scholarly journals Evaluation of mineral status in hypothyroidism in a tertiary care centre

2020 ◽  
Vol 8 (2) ◽  
pp. 667
Author(s):  
Shikha Saxena ◽  
Prem Chandra Srivastava ◽  
Rashmi Katyal ◽  
Biswajit Das ◽  
Sileena Jaideep Pannu
Keyword(s):  
Serum Calcium ◽  
Serum Magnesium ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Serum Zinc ◽  
The Body ◽  
Endocrine Disorders ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Mineral Status

Background: Hypothyroidism is known to be the commonest form of endocrine disorders and has been linked with disturbances in various minerals metabolism. Calcium, phosphorus and magnesium and trace element zinc are required for many enzymes in various metabolic pathways which are directly or indirectly regulated by thyroid hormones. Aim and objectives of the study was to estimate serum zinc, calcium, magnesium and phosphorus in hypothyroid patients, with the objectives to evaluate any relationship with TSH and to compare them with euthyroid controls.Methods: The analytical cross-sectional study included 50 hypothyroid subjects with TSH levels >4.5 mcg IU/mL and 50 euthyroid subjects of 20-50 years in RMCH, Bareilly. TSH was estimated by ECLIA, serum calcium and phosphorus were estimated by autoanalyzer and serum zinc & magnesium by the kit method using semi autoanalyzer. All the biochemical parameters were expressed as median with Interquartile Range (IQR). Mann-Whitney test was applied to compare the parameters of cases and control. Spearman’s rank correlation coefficient 2-tailed was used to correlate the parameters among the cases.Results: A significantly decreased level of serum calcium and increased level of serum magnesium and phosphorus were observed in hypothyroid cases. A significant negative correlation between TSH and serum calcium while a significant positive correlation of serum magnesium and phosphorus with TSH was observed.Conclusions: The indexed study indicates the significant effect of overt or subclinical hypothyroidism over the mineral status of the body which may have inconsistent effect over the various metabolism and enzymes and thereby clinical manifestations.

scholarly journals Role of Macronutrients in the Prevention of Pre-Eclampsia - A Cross Sectional Study at a Tertiary Care Centre in North India

2020 ◽  
Vol 7 (42) ◽  
pp. 2414-2419
Author(s):  
Vandana Gangadharan ◽  
Gaurie Srivastava ◽  
George Koshy ◽  
Varghese Koshy
Keyword(s):  
Serum Calcium ◽  
Serum Magnesium ◽  
Tertiary Care ◽  
Normal Pregnancy ◽  
Maternal Serum ◽  
North India ◽  
Base Line ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Calcium And Magnesium

BACKGROUND Role for macronutrient supplementation in preventing pre-eclampsia is now backed with evidence which is evolving rapidly. We wanted to study and compare serum calcium and serum magnesium levels in pre-eclamptic women and women with normal pregnancy. METHODS 30 women with normal pregnancy and 30 women with preeclampsia were included in the study. Their serum calcium and magnesium levels were estimated using colorimetry. RESULTS Serum calcium levels in normotensive patients was found to be 9.3 ± 0.95 mg / dL and in preeclamptic patients, it was 8.3 ± 0.85 mg / dL. Serum magnesium levels were found to be 1.94 ± 0.24 mg / dL and 1.57 ± 0.125 mg / dL in normal and pre-eclamptic women respectively. These values were affected by age, parity, BMI, socio-economic status, and nutrition before and during pregnancy. CONCLUSIONS Low values of maternal serum calcium along with magnesium are related to preeclampsia which might have an association in this disease. We also realised that evaluation of base-line levels of serum calcium and magnesium are necessary during early pregnancy. Constant monitoring of blood pressure is also essential. Adequate intake of macronutrients is essential for maintaining health of both mother and child. Hence, measurable and realistic efforts must be made along these lines. Nutrition is a key concern in pregnant women and is pivotal in ensuring health in this vulnerable group. KEYWORDS Pre-Eclampsia, Serum Calcium, Serum Magnesium, Pregnancy, Macronutrients

Magnitude of thyroid dysfunction among antenatal women attending tertiary care centre

2019 ◽  
Vol 8 (11) ◽  
pp. 4371
Author(s):  
Deepa Shanmugham ◽  
Deepak Kannan Saravanan ◽  
Priyanka Shah
Keyword(s):  
Thyroid Dysfunction ◽  
Tertiary Care ◽  
Thyroid Function Test ◽  
First Trimester ◽  
Endocrine Disorders ◽  
Tertiary Care Centre ◽  
Free T4 ◽  
Cross Sectional ◽  
High Prevalence ◽  
The Mean

Background: Thyroid disorders constitute one of the most common endocrine disorders in pregnancy. However, there is no universal guidelines to screen every Pregnant Woman for Thyroid dysfunction in India. This study was conducted to evaluate the magnitude of thyroid dysfunction among ante natal mothers in a tertiary care centre.Methods: This was a cross sectional observational study conducted on ante natal mothers for a period of 6 months. All consecutive ante natal mothers in their first trimester were included in this study. Exclusion criteria was pre-gestational thyroid dysfunction, hypertension and diabetes mellitus. After obstetric examination and investigation, thyroid function test (Free T4 and TSH) was done in all patients.Results: Mean age of the patients enrolled was 26.2±3.54 years. Mean gestational age at which they underwent screening was 9±2 weeks. The mean BMI of the study patients was 21.7±4. The prevalence of hypothyroidism in antenatal mothers was 14.5%. 5 patients (5.5%) had hyperthyroidism. The calculated mean TSH value was 4.26 mIU/L.Conclusions: Universal screening for thyroid dysfunction during pregnancy should be made mandatory in India due to high prevalence, in order to prevent maternal and foetal complications.

Clinical Profile and Outcome in Patients with Snake Bite in a Tertiary Care Centre in Kerala

2021 ◽  
Vol 8 (41) ◽  
pp. 3567-3572
Author(s):  
Satish Kumar ◽  
Sanghamithra Prabhakaran
Keyword(s):  
Renal Failure ◽  
Secondary Infection ◽  
Tertiary Care ◽  
The Body ◽  
Snake Bite ◽  
Clinical Profile ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Severe Degree

BACKGROUND The clinical profile and outcome of snake bite varies from place to place and depends on a number of factors including the type of snake bite, place of snake bite, time of bite, season, and duration of presentation after bite. The clinical profile, factors affecting the outcome and the outcome have not been previously well studied. METHODS This is a cross-sectional observational study conducted for a duration of six months from January 2021 to June 2021. Subjects meeting inclusion criteria were enrolled in the study group after obtaining written consent. Patients were evaluated based on the standard pro-forma with detailed history and clinical examination. All relevant investigations to assess systemic envenomation, treatment and outcome were documented in all the patients. RESULTS In the study, 204 (68 %) were male patients and 96 (32 %) were female patients. 108 (36 %) were admitted with venomous snake bite and 192 (64 %) were with non-poisonous snake bite. 52 patients had snake bite on the upper extremities, 234 had snake bite on the lower extremities, 8 patients had snake bite on the trunk whereas 6 patients had bite on other areas of the body. 202 patients had swelling at the bite site, 222 had pain at the site of bite, 86 patients had oozing of blood and 6 patients had vague somatic symptoms. 132 patients had local oedema, 148 had local tenderness, 66 patients had skin necrosis and 16 patients developed blisters at the site of bite. 124 patients had systemic manifestations of which 24 patients had vomiting, 12 patients developed abdominal pain, 10 patients developed anuria/oliguria, 14 patients developed hypotension, 12 patients developed bleeding manifestations, 10 patients developed neurological symptoms and 2 snakebite patients had syncope. Complications and mortality in poisonous snake bite due to renal failure was observed in 38 patients with a mortality of 1 patient, 10 patients developed intravascular haemolysis, 8 patients developed unexplained hypotension, 18 patients developed secondary infection, 4 patients developed intra-cerebral bleeding and 15 patients developed neurotoxity with a mortality of 2 patients. CONCLUSIONS Snake bite is a common problem encountered in tertiary care centres and the most common encountered type of snakebite was haemotoxic bite. Pain at the bite site was the commonest symptom and tenderness at bite site was the commonest sign in patients with snake bite. Mortality in venomous bite was 3.7%. Prolonged bite to needle time, development of renal failure, leukocytosis, neurotoxicity and severe degree of coagulopathy were factors associated with adverse outcome. KEYWORDS Clinical Profile, Outcome, Snake Bite, Tertiary Care Centre

scholarly journals Socio-demographic and Clinical Characteristics of Patients with Ulcerative Colitis at a Tertiary Care Centre in Nepal

2019 ◽  
Vol 8 (2) ◽  
pp. 26-29
Author(s):  
Rahul Pathak ◽  
Tshering Wangdi Sherpa ◽  
Anurag Jha ◽  
Rabin Hamal ◽  
Sabin Thapallya
Keyword(s):  
Ulcerative Colitis ◽  
Clinical Characteristics ◽  
Severe Disease ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Common Symptom ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Colonoscopic Examination

Introduction: The prevalence of ulcerative colitis (UC) has gradually increased in Asia over the last few decades. However, there is a paucity of data regarding UC in Nepal. This study analyzed the socio-demographic and clinical characteristics of patients hospitalized with UC. Methods: This is a hospital based, cross-sectional study. Data was collected among 100 individuals admitted to the hospital with UC from June 2016 to May 2018. A descriptive analysis of the demographic and clinical characteristics was done. Results: Of the 100 patients 51 were male (M:F ratio 1.04:1). Average age at diagnosis was 38}12.53 years. 55% of the patients were Brahmins, 16% Kshetris, 8% Newars, 1% Muslim while the remaining 20% belonged to other indigenous ethnic groups. 79% of the patients were newly diagnosed cases while remaining 21% were admitted for acute flares of the disease. Rectal bleeding (85%) was the most common symptom followed by diarrhea (70%), tenesmus (63%), urgency (61%), pain abdomen (44%), weight loss (14%), fever (7%) and constipation (4%). Clinically, 41% had mild, 46% had moderate and 12% had severe disease activity. Extra intestinal manifestations were seen only in 12% of the patients. On colonoscopic examination, 41% had proctitis, 46% had left sided colitis and 13% had extensive colitis. Conclusion: Our study showed some differences in the demographic variables as well as clinical manifestations in the patients when compared to data from the west and even other Asian countries like India and China. Larger population-based studies are needed to better understand the epidemiology and characteristics of the disease in Nepal.  

scholarly journals PHOTOTHERAPY

2015 ◽  
Vol 22 (12) ◽  
pp. 1541-1545
Author(s):  
Sadida Bahawal ◽  
Umm-Ul- Baneen Naqvi ◽  
Mehboob Alam Siddiqui ◽  
Dr.Shakil Ahmad ◽  
Imran Sarwar
Keyword(s):  
Serum Calcium ◽  
Tertiary Care ◽  
Full Term ◽  
Preterm Neonates ◽  
P Value ◽  
Inclusion Criteria ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Term Neonates ◽  
Paediatric Unit

Hyperbilirubinemia is the most common abnormal physical finding in first fewweeks of lif and its most common management is phototherapy. Amongst other commoncomplications a less known complication of phototherapy is hypocalcemia. Objectives: To studythe incidence of phototherapy induced hypocalcemia in neonates and to have a comparisonbetween preterm and term neonates. Study design: Descriptive cross-sectional study.Setting: Paediatric Unit II DHQ Hospital Faisalabad, which is a tertiary care centre for all kind ofpatients. Duration of study with dates: Six months from 1-11-2012 to 30-04-2013. Methods:196 neonates with hyperbilirubinemia full term / preterm neonates admitted in pediatric DHQhospital faislabad were selected. Inclusion criteria. 1) Hyperbilirubinemia. 2) No hypocalcemiaon admission. 3) Received phototherapy for hyperbilirubinemia. Serum Calcium levels weremeasured in all neonates before and 48 hours after receiving phototherapy. Incidence ofhypocalcemia among all neonates was calculated as an absolute percentage and the samplepopulation was also divided into preterm / full term neonates to evaluate the incidence ofhypocalcemia in these two groups individually. RESULTS: Mean serum calcium in neonateswas 7.5+- 1.5 mg / dl .16.84 % of neonates were found to have calcium level below the cut offvalue. 33 out of 196 developed hypocalcemia after phototherapy and out of these 54 % werepreterm and 45 % were term neonates < P-value (0.01)>. Conclusion: Phototherapy induceshypocalcemia in neonates more so in preterm neonates. Impact: Consideration for additionalcalcium supplementation should be undertaken in all neonates undergoing phototherapy andfurther randomized trials need to be done with these concerns.

Serum Zinc Levels in Cirrhotic Patients Attending General and Specialty Hospitals, Yangon

2019 ◽  
Vol 31 (3) ◽  
pp. 251-256
Keyword(s):  
Clinical Practice ◽  
Hepatic Encephalopathy ◽  
Zinc Deficiency ◽  
Serum Zinc ◽  
Zinc Level ◽  
The Body ◽  
Serum Zinc Level ◽  
Cross Sectional ◽  
Cirrhotic Patients ◽  
Cirrhosis Of Liver

Cirrhosis of liver is one of the common medical problem in daily clinical practice and one of the leading causes of morbidity and mortality. Zinc is an essential trace elements for human and plays in many biological roles in the body. Among them, zinc deficiency is thought to be involved in metabolism of ammonia and causes hyperammonia that worsen hepatic encephalopathy. This study aimed to find out the severity of cirrhosis of liver was by Child Turcotte Pugh score and to investigate the associations between serum zinc level and severity of cirrhosis. A hospital-based cross-sectional descriptive study was performed on 78 patients with different underlying causes of cirrhosis of liver at the Medical Units of Yangon General Hospital and Yangon Specialty Hospital. Among the study population, Child grade A was found to be 28.21%, Child grade B was 30.77% and Child grade C was 41.03%. Regarding result of serum zinc level, 62.8% were low level, 28.2% were within normal level and 8.9% were high level. Mean value of serum zinc level in grade A was 0.68 mg/l, grade B was 0.54 mg/l and grade C was 0.48 mg/l (p=0.00). It was found out that there was a high prevalence of zinc deficiency in severe cirrhotic patients. The zinc level was significantly lowest among patients with Child-Pugh C as compare to those with Child-Pugh B and C. Severity of zinc deficiency should be requested for supplementation therapy in cirrhotic patients as to prevent complications such as hepatic encephalopathy, hepatocellular carcinoma and liver failure. Screening for zinc deficiency may need in these patients with more advanced cirrhosis because it seems to be a marker of advanced liver disease and it can be deducted that awareness of serum zinc level among cirrhotic patients is very important in clinical practice.

scholarly journals Should we care about Plasmodium vivax and HIV co-infection? A systematic review and a cases series from the Brazilian Amazon

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Paola López Del-Tejo ◽  
Nadia Cubas-Vega ◽  
Cecilia Caraballo-Guerra ◽  
Bernardo Maia da Silva ◽  
Jefferson da Silva Valente ◽  
...  
Keyword(s):  
Systematic Review ◽  
Plasmodium Vivax ◽  
Vivax Malaria ◽  
Tertiary Care ◽  
Case Series ◽  
Brazilian Amazon ◽  
Outcome Data ◽  
Malaria Episode ◽  
Tertiary Care Centre ◽  
Cross Sectional

Abstract Background Malaria and HIV are two important public health issues. However, evidence on HIV-Plasmodium vivax co-infection (HIV/PvCo) is scarce, with most of the available information related to Plasmodium falciparum on the African continent. It is unclear whether HIV can change the clinical course of vivax malaria and increase the risk of complications. In this study, a systematic review of HIV/PvCo studies was performed, and recent cases from the Brazilian Amazon were included. Methods Medical records from a tertiary care centre in the Western Brazilian Amazon (2009–2018) were reviewed to identify HIV/PvCo hospitalized patients. Demographic, clinical and laboratory characteristics and outcomes are reported. Also, a systematic review of published studies on HIV/PvCo was conducted. Metadata, number of HIV/PvCo cases, demographic, clinical, and outcome data were extracted. Results A total of 1,048 vivax malaria patients were hospitalized in the 10-year period; 21 (2.0%) were HIV/PvCo cases, of which 9 (42.9%) had AIDS-defining illnesses. This was the first malaria episode in 11 (52.4%) patients. Seven (33.3%) patients were unaware of their HIV status and were diagnosed on hospitalization. Severe malaria was diagnosed in 5 (23.8%) patients. One patient died. The systematic review search provided 17 articles (12 cross-sectional or longitudinal studies and 5 case report studies). A higher prevalence of studies involved cases in African and Asian countries (35.3 and 29.4%, respectively), and the prevalence of reported co-infections ranged from 0.1 to 60%. Conclusion Reports of HIV/PvCo are scarce in the literature, with only a few studies describing clinical and laboratory outcomes. Systematic screening for both co-infections is not routinely performed, and therefore the real prevalence of HIV/PvCo is unknown. This study showed a low prevalence of HIV/PvCo despite the high prevalence of malaria and HIV locally. Even though relatively small, this is the largest case series to describe HIV/PvCo.

EXPERIENCE OF EVALUATION OF PATIENTS OF OBSTRUCTIVE JAUNDICE BY SONOGRAPHY AND MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY AT A TERTIARY CARE CENTRE IN EASTERN INDIA

2021 ◽  
pp. 61-64
Author(s):  
Santosh Kumar Prasad ◽  
Nupur Nupur ◽  
Akshit Pathak ◽  
Indra Shekhar Thakur ◽  
Vijay Shankar Prasad
Keyword(s):  
Magnetic Resonance ◽  
Obstructive Jaundice ◽  
Hepatic Duct ◽  
Tertiary Care ◽  
Pancreatic Head ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Stricture Formation ◽  
Tertiary Care Centre ◽  
Left Hepatic Duct ◽  
Cross Sectional

INTRODUCTION: Jaundice means yellow due to the yellowish discolouration of skin, sclera, and mucous membrane seen in jaundice caused by bilirubin pigment. It is divided in to two forms obstructive(surgical) and non- obstructive (non-surgical). AIM AND OBJECTIVE: To evaluate patients of obstructive jaundice by sonography and magnetic resonance cholangiopancreatography and compare the reporting and ndings by both the modalities. MATERIALS AND METHODS: Cross sectional observational study done from November 2018 to October 2020 and consists of 32 patients who had clinical jaundice and consented to being subjected to both ultrasound and MRCP. OBSERVATIONS:Both USG and MRCP were able to detect extrahepatic CBD dilatation equally in 25 patients. In 5(15.6%) patients USG and MRI both demonstrated intrahepatic mass causing obstruction at the level of conuence of right and left hepatic duct or CHD. Ultrasonography was able to detect the intrinsic mass of the extrahepatic common bile duct in 2(6.2%) patients out of 32 patients in our study population. MRCP could detect the same in 6(18.7%) patients. In our study narrowing of CBD with stricture formation and upstream dilatation of biliary tree was identied in 10(31.2%) patients on MRCP. Ultrasound could diagnose the same in one patient. Both USG and MRCP were able to detect pancreatic head mass as well as pseudocyst. CONCLUSION: The accuracy of MRCP was found to be comparable to that of ERCP for diagnosis of etiology for obstructive jaundice. MRCP allows better lesion characterization and assessment. However, the patchy availability of MR machines become the main achilles heel for the surgeons as well as the radiologists. Hence the valuable role of the omnipresent ultrasonography become immense.

A CLINICOEPIDEMIOLOGICAL STUDY ON PAEDERUS DERMATITIS IN A TERTIARY CARE CENTRE, CHENNAI

2021 ◽  
pp. 25-27
Author(s):  
P. Mohan ◽  
P. Revathi Guru ◽  
V. Sudha ◽  
L. Balamurugan ◽  
Pavithra Gunasekaran ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Sudden Onset ◽  
The Body ◽  
Care Hospital ◽  
Age Group ◽  
Common Condition ◽  
Tertiary Care Centre ◽  
Linear Lesions ◽  
Paederus Dermatitis

Paederus dermatitis is a form of irritant contact dermatitis due to contact with certain insects of the genus Paederus presenting with mostly erythematous linear lesions of sudden onset on exposed parts of the body. To study the clinico epi Aim: demiological features in patients with Paederus dermatitis. A retrospective analysis of clinicoepidemiological Materials & Methods: features of patients affected with Paederus dermatitis who had attended the Dermatology OPD, in a tertiary care hospital between January 2018 to December 2019 was done. All the required data had been collected from the OPD records and details were tabulated and analysed. A total of 56 patients had been affected with Result: Paederus dermatitis during the study period, of which 32 were males and 24 were females. 41out of 56 (73.21%) of patients presented between the months of August and December. Most common age group affected were between 11 to 30 yrs, with front and back of neck being the most common affected sites. In 42 out of the 56 patients the lesions resolved with post inammatory hyperpigmentation. Conclusion: Paederus dermatitis is a common condition that is often misdiagnosed and hence awareness is required for the clinicians and the general public to prevent it.

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